血清游离前列腺特异抗原在前列腺癌鉴别诊断中的意义  

The clinical significance of the proportion of free PSA to total PSA in differential diagnosis of prostate cancer

作　　者：曹颖平[1] 陈卫闽[1] 罗心绮[1] 张勇[2] 

机构地区：[1]福建医科大学附属协和医院,福建福州3500012 [2]上海第二医科大学免疫学研究所,上海200025

出　　处：《宁夏医学杂志》2002年第7期387-389,共3页Ningxia Medical Journal

摘　　要：目的　探讨血清游离前列腺特异抗原 (PSA)百分比在前列腺癌鉴别诊断中的意义。方法　用微粒子酶免法对 1 35例前列腺癌和 1 1 7例前列腺增生 (BPH)患者的血清总PSA、游离PSA及游离 /总前列腺抗原百分比 (F/T百分比 )进行比较。结果　当包含所有患者时 ,前列腺癌组和BPH患者的血清总PSA和F/T百分比均有明显差异 (P <0 .0 1 ) ,但当总PSA在 4 .0 - 1 0 .0ng/ml区间时 ,两组患者血清的总PSA无显著差异 ,而前列腺癌患者组的血清F/T百分比却明显低于BPH组 (P <0 .0 1 )。通过敏感性和特异性的分析表明 ,当总PSA在 4 .0 -1 0 .0ng/ml区间时 ,在相同敏感性的情况下 ,F/T百分比对前列腺癌诊断的特异性明显高于总PSA。结论　当血清总PSA在 4 .0 - 1 0 .0ng/ml区间时 。Objectives This study examined the clinical significance of the proportion of free prostate specific antigen(PSA) to total PSA in the differential diagnosis of prostate cancer with an emphasis on patients with total PSA values between 4.0 and 10.0 ng/ml(the diagnostic gray zone).Methods The levels of serum total PSA,free PSA and the proportion of free PSA to total PSA was studied in 135 patients with prostate cancer and 117 patients with benign prostatic hyperplasia(BPH),using microparticle enzyme-immunoassay(MEIA).Results When all subjects were include,both total PSA and the proportion of free PSA to total PSA significantly differentiated between patients with prostate cancer and patients with BPH(P<0.01).However,in men with total PSA values between 4.0 and 10.0ng/ml,the proportion of free PSA to total PSA significantly differentiated between patients with prostate cancer and patients with BPH(P<0.01) where the total PSA did not(P>0.05).Among this subgroup of patients,the analysis of sensitivity and specificity show that the proportion of free PSA to total PSA had a clearly higher specificity compared with that of the total PSA at the same level of sensitivity.Conclusions The proportion of free PSA to total PSA enhance the ability to distinguish BPH from prostate cancer while retain high sensitivity for detecting cancer in men who present with total PSA levels between 4.0 and 10.0 ng/ml .

关 键 词：血清 前列腺特异抗原 前列腺癌 鉴别诊断 微粒子酶免法 

分 类 号：R737.25[医药卫生—肿瘤]